The isolated population of the Island of Susak was thoroughly studied by a multidisciplinary team of the Croatian Academy of Sciences and Arts in early 1950's. Recently, a team of scientists revisited the island. This paper describes the main characteristics of the transition process during which a massive exodus occurred with 90% of the island's population migrating to New Jersey, USA. We summarise the differences in lifestyle, economy, social structure and sense of identity between the historic (1950's) and contemporary (2001) Susak population. We applied contemporary methods (analysis of microsatellite DNA polymorphisms) to investigate local myths about extreme levels of inbreeding and genetic homogeneity among the Susak islanders. Analysis of short-tandem-repeat (STR) loci showed that Susak displayed characteristics of a small homogeneous breeding isolate. The average heterozygosity was found to be low compared to outbred populations. The signature of a recent severe bottleneck could be detected. Analysis of 8 markers located on Xq13-21 in 71 individuals suggested extensive level of linkage disequilibrium (LD). A migrant study was designed to investigate the effects of large environmental changes (Susak vs. USA) and inbreeding (Susak vs. Croatian general population) on some biologically important quantitative traits, such as blood pressure and serum lipids. The results confirmed the positive correlation between inbreeding level and blood pressure that has been reported in the literature on several occasions. The last remnants of this traditional island community will soon be lost forever.